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Liver fat accumulation within the 'normal range' is associated with the presence of metabolic syndrome traits
Emily Brown1, Josh Bilson2, Uazman Alam1
1Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool University Hospitals NHS Foundation Trust, University Hospital Aintree, Liverpool, UK.
Aims:
The primary objective of this cross-sectional study was to re-examine the liver fat thresholds associated with metabolic health and number of metabolic syndrome (MetS) traits.
Methods:
In this cross-sectional study, 597 participants (99.7 % white European) underwent assessment of i) cardiometabolic health with individual MetS traits ii) alcohol consumption and iii) steatotic liver disease (SLD), defined by MRI-PDFF or proton spectroscopy (1H-MRS) liver fat ≥5.56 %.
Results:
The median (IQR) liver fat was 0.4 % (0.9) in 30 subjects without MetS traits and 6.7 % (15.4) and 16.7 % (20.1) in 117 and 108 subjects with 3 and 5 MetS traits respectively. SLD was associated with each MetS trait (increased blood pressure, central obesity, dysglycaemia, high triglyceride and low HDL-C concentrations; all p < 0.001). There was an increase in liver fat (%) according to increasing number of MetS traits (p < 0.001). There was an increase in every MetS trait with liver fat categories below 5.56 % (i.e. ≥1 % and ≤1.85 %, >1.85 % and <5.56 %).
Conclusions:
Previously defined normal levels of liver fat are not associated with optimal metabolic health (no MetS traits). Small increments in liver fat, even within a pre-defined normal range, are associated with a progressive increase in the number of MetS traits.
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